Blackmores Institute

The randomised controlled trial, Women First Preconception Maternal Nutrition Trial, studied 972 newborns of mothers who were poor, rural, unselected on basis of nutritional status and had been randomised to receive a daily lipid-based micronutrient supplement commencing at least three months prior to conception (Arm 1), in the first trimester (Arm 2) or not at all (Arm 3).
 
 Results showed that anthropometric outcomes were consistently more favourable when maternal nutrition supplements were commenced at least three months prior to conception indicating the benefits to foetal growth with improving women’s nutrition.
 
 “Despite recent declines in frequency of stunting, 38 percent of children under five years of age in South Asia are still stunted, with rates exceeding one-third each in Pakistan, India, Bangladesh, and Nepal. This region, because of the size of the population and high rates of stunting, accounts for 40 percent of the global burden of stunting.”
 
 “The causes of early childhood stunting in South Asia, as elsewhere, are multifactorial. However, low birth weight, especially low birth size for gestational age is a major factor with South Asia accounting for over 50 percent of the global occurrence of low birth weight - Pakistan and India being major contributors to this high figure,” the authors explained.
 
 According to the study, although the importance of maternal nutrition is recognised to improve the health of the foetus, attention to the nutrition of non-pregnant women is only beginning to grow, and as such, there needs to be considerable ramping-up of evidence-based strategies (and test new strategies) to improve women’s nutrition and as a result the foetal nutrition.
 
 “The goal of this trial was not to evaluate a specific nutrition product or combination of products but rather to use these products to advance our understanding of the extent to which deficits in foetal growth could be corrected by commencing nutrition interventions very early in pregnancy or for a substantial time prior to conception in women of childbearing age in these and similar populations.
 
 “It is quite possible that greater effects could be achieved with further modifications of the interventions, perhaps especially if guidelines for maternal gestational weight gain could be matched, and that these may be achievable with sustainable solutions including education and dietary improvements,” the authors said.
 
 The authors acknowledged that a limitation of this trial was that it only addressed one environmental factor, maternal nutrition, when challenged with a multifactorial aetiology. 
 
 “Commencing a relatively comprehensive nutrition supplement at least three months prior to conception for women unselected for anthropometric indicators of nutritional status was associated with decreases of 44% in stunting, 24% in wasting, and 26% SGA when compared to the control group. These results provide quantitative information on the benefits to foetal growth achievable by improvement in intake of energy, protein, and micronutrients commencing before the start of the second trimester of gestation without any other interventions directed to improvement of the poor environments in which the participants lived.”
 
 “The effects of the nutrition supplement commenced at least 3 months prior to conception support enhanced efforts to improve the nutrition of all women of child-bearing age in resource-poor populations in these and similar environments in order to diminish impairment of foetal growth,” the authors concluded.
 
 Source:
 PLoS One. 2020. DOI: <a href="https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0218960">10.1371/journal.pone.0218960</a>

Improving nutrition of women before conception leads to significant correction of deficits in birth weight and length, a new study in journal PLoS One, has reported.

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